HESI RN
HESI Leadership and Management
1. When caring for a male client with diabetes insipidus, what does Nurse Juliet expect to administer?
- A. Vasopressin (Pitressin Synthetic)
- B. Furosemide (Lasix)
- C. Regular insulin
- D. 10% dextrose
Correct answer: A
Rationale: The correct answer is A: Vasopressin (Pitressin Synthetic). Vasopressin is the treatment of choice for diabetes insipidus as it replaces the deficient antidiuretic hormone. Furosemide (Lasix) (choice B) is a diuretic and would exacerbate fluid loss, making it inappropriate for diabetes insipidus. Regular insulin (choice C) is used for diabetes mellitus, not diabetes insipidus, which involves water balance rather than glucose regulation. 10% dextrose (choice D) is used to treat hypoglycemia, not diabetes insipidus.
2. Which nursing diagnosis takes the highest priority for a female client with hyperthyroidism?
- A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
- B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
- C. Body image disturbance related to weight gain and edema
- D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
Correct answer: D
Rationale: The correct answer is D: Imbalanced nutrition: Less than body requirements related to thyroid hormone excess. In hyperthyroidism, increased metabolic rate leads to increased nutritional needs, causing weight loss and muscle wasting. Therefore, addressing imbalanced nutrition due to excessive thyroid hormone is a priority. Choice A is incorrect as hyperthyroidism typically leads to weight loss, not weight gain. Choice B is less of a priority as skin issues are secondary to the metabolic disturbances caused by hyperthyroidism. Choice C, body image disturbance, is important but addressing the client's nutritional needs should take precedence to prevent further complications.
3. A client with DM is experiencing symptoms of hypoglycemia. Which action should the nurse take first?
- A. Give the client a glass of orange juice.
- B. Administer insulin as ordered.
- C. Check the client's blood glucose level.
- D. Notify the healthcare provider.
Correct answer: C
Rationale: The correct first action when a client with DM is experiencing symptoms of hypoglycemia is to check the client's blood glucose level. This step is crucial to confirm hypoglycemia before initiating any treatment. Giving the client orange juice (Choice A) is a common intervention for treating hypoglycemia, but it should not be done before confirming the blood glucose level. Administering insulin (Choice B) is not appropriate for hypoglycemia as it would further decrease the blood glucose levels. Notifying the healthcare provider (Choice D) can be important, but the immediate priority is to assess the blood glucose level to guide treatment.
4. A nurse is preparing to administer NPH insulin to a client with DM. The nurse notes that the NPH insulin vial is cloudy. The nurse should:
- A. Obtain a new vial of NPH insulin.
- B. Draw up the cloudy insulin as ordered.
- C. Shake the vial vigorously before drawing up the insulin.
- D. Warm the insulin to room temperature before administration.
Correct answer: B
Rationale: The correct answer is to draw up the cloudy insulin as ordered. NPH insulin is inherently cloudy due to its suspension of insulin crystals. Shaking the vial vigorously can lead to denaturation of the insulin molecules, altering its efficacy. Warming NPH insulin is not necessary as it can cause breakdown of insulin molecules. The nurse should gently roll the vial between hands to mix it before drawing it up to ensure an even distribution of insulin in the suspension.
5. Which advice is most beneficial for a new nurse manager?
- A. Strive to embody the manager your staff desires while also aligning with your administration's expectations.
- B. Keep in mind that it may take 6 months to feel at ease in a new role.
- C. Begin by mentoring other novice nurse managers.
- D. Participate in substantial personal growth endeavors.
Correct answer: B
Rationale: The most helpful advice for a new nurse manager is to understand that it can take up to 6 months to feel comfortable in a new position. This allows the individual to manage their expectations and give themselves time to adapt to their new role. Choice A may be overwhelming and could cause conflicting priorities for the new nurse manager. Choice C, while valuable, might not be the immediate focus for someone new to the role. Choice D, although important, may not be as time-sensitive as the adjustment period in the new position.
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